The U.S. recorded more than 3,100 covid-19 deaths in a single day, obliterating the record set last spring, while the number of Americans in the hospital with the virus has eclipsed 100,000 for the first time and new cases have begun topping 200,000 a day, according to figures released Thursday.
The three benchmarks together showed a country slipping deeper into crisis, with perhaps the worst yet to come, in part because of the delayed effects from Thanksgiving, when millions of Americans disregarded warnings to stay home.
Meanwhile, President-elect Joe Biden said Thursday that he will ask Americans to commit to 100 days of wearing masks as one of his first acts.
Biden has frequently emphasized mask-wearing as a "patriotic duty," and during the campaign floated the idea of instituting a mandate, which he later acknowledged would be beyond the ability of the president to enforce.
Speaking with CNN, Biden said he would make the request of Americans on Jan. 20: "On the first day I'm inaugurated, I'm going to ask the public for 100 days to mask. Just 100 days to mask -- not forever, just 100 days. And I think we'll see a significant reduction" in the virus.
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Across the U.S., the current surge has swamped hospitals and left nurses and other health care workers shorthanded and burned out.
"The reality is, December and January and February are going to be rough times. I actually believe they are going to be the most difficult time in the public health history of this nation," Dr. Robert Redfield, head of the Centers for Disease Control and Prevention, said Wednesday.
In the meantime, states are drafting plans on who will go to the front of the line when the first doses of a covid-19 vaccine become available this month.
With initial supplies limited, governors and other state officials are weighing both health and economic concerns in deciding the order in which the shots will be dispensed.
States face a deadline today to submit requests for doses of the first vaccine, from Pfizer, and specify where they should be shipped, and many appear to be heeding nonbinding guidelines adopted this week by the Centers for Disease Control and Prevention to put health care workers and nursing home patients first.
But they're also facing a multitude of decisions about other categories of residents -- some specific to their states, some vital to their economies.
STATES' SPECIFICS
Colorado's draft plan, which is being revised, puts ski resort workers who share close quarters in the second phase of vaccine distribution, in recognition of the $6 billion industry's linchpin role in the state's economy.
In Nevada, where officials have stressed the importance of bringing tourists back to the Las Vegas Strip, authorities initially put nursing home patients in the third phase, behind police officers, teachers, airport operators and retail workers. But they said they would revise that plan to conform to the CDC guidance.
In Arkansas, Gov. Asa Hutchinson said health care and long-term care facility workers are the top priority, but the state was still refining who would be included in the next phase. A draft vaccination plan submitted to the CDC in October listed poultry workers along with other essential workers such as teachers, law enforcement and correctional employees in the so-called 1B category.
Poultry is a major part of Arkansas' economy, and nearly 6,000 poultry workers have tested positive for the virus since the pandemic began, according to the state Health Department.
"We know these workers have been the brunt of large outbreaks not only in our state, but also in other states," said Dr. Jose Romero, the state's health secretary and chairman of the CDC's Advisory Committee on Immunization Practices.
Nationwide, the coronavirus is blamed for more than 276,000 deaths and 14 million confirmed infections.
The U.S. recorded 3,157 deaths Wednesday alone, according to the tally kept by Johns Hopkins University. That's more than the number of people killed in the Sept. 11, 2001, terrorist attack.
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The number of Americans in the hospital with the coronavirus likewise hit an all-time high Wednesday at more than 100,000, according to the COVID Tracking Project. The figure has more than doubled over the past month. And new cases per day have begun topping 200,000, by Johns Hopkins' count.
Keeping health care workers on their feet is considered vital to dealing with the crisis. And nursing home patients have proven highly vulnerable to the virus. Patients and staff members at nursing homes and other long-term care centers account for 39% of the nation's deaths.
OTHER STATES
In Minnesota, firefighter groups asked the governor to be placed in the first group.
The Illinois plan gives highest priority to health care workers but also calls for first responders to be in the first batch to get the shot.
Other states are struggling with where to put prisoners in the pecking order.
Arizona Gov. Doug Ducey said he wants teachers to get priority so schools can stay open. Two California lawmakers asked for that, too, saying distance learning is harming students' education.
"Our state's children cannot afford to wait," wrote Republican Assemblyman Jordan Cunningham and Democratic Assemblyman Patrick O'Donnell. "This is too important to overlook or sweep aside."
Texas is putting hospital staff, nursing home workers and paramedics at the top of the list, followed by outpatient medical employees, pharmacists, funeral home workers and school nurses. Nursing home patients did not make the cut for the first phase.
Likewise, Utah officials said Thursday that frontline health care workers will take top priority, with the five hospitals treating the most covid-19 patients getting the first doses. State health officials said additional doses probably will be available in February and March for more hospital workers, and that essential workers -- including police officers, firefighters and teachers -- also will be prioritized.
Advocates strongly expressed frustration over the way some states are putting medical workers ahead of nursing home residents.
"It would be unconscionable not to give top priority to protect the population that is more susceptible or vulnerable to the virus," said John Sauer, head of LeadingAge in Wisconsin, a group representing nonprofit long-term care facilities.
He added: "I can't think of a more raw form of ageism than that. The population that is most vulnerable to succumbing to this virus is not going to be given priority? I mean, that just says we don't value the lives of people in long-term care."
CALIFORNIA RESTRICTIONS
California will probably order most of its businesses to close or limit capacity in the coming days, Gov. Gavin Newsom said Thursday, part of new rules triggered when fewer than 15% of beds are available in intensive care units for regional hospital networks.
Newsom said four of the state's five regions -- excluding the San Francisco Bay area -- will meet that threshold within a day or two. When they do, the state will order the closure of hair salons and barbershops; bars, breweries and distilleries; casinos; and both indoor and outdoor playgrounds.
Restaurants would be limited to take-out and delivery, while retailers would have to limit customers to 20% of capacity during the holiday shopping season.
Once the rules are triggered, regions would have 48 hours to implement them, and they must stay in effect at least three weeks. The rules don't apply to public schools.
"The bottom line is, if we don't act now, our hospital system will be overwhelmed," Newsom said. "This is the most challenging moment since the beginning of this pandemic."
The new rules recognize the strain placed on hospital networks that serve multiple counties. California's virus hospitalizations have nearly quadrupled since mid-October.
The rules would be a return to the kind of lockdown first imposed in March, when the pandemic was new and public health officials were scrambling to figure out how to contain the spread.
The fall holiday season, coupled with colder weather driving more people inside -- where the virus flourishes -- prompted warnings of a second wave of covid cases that could dwarf anything the state had seen previously. Those prophecies came true last month, as new cases increased at a rate that astonished public health experts.
California is now averaging nearly 15,000 new cases a day.
RELIGIOUS RULES REVISITED
The U.S. Supreme Court on Thursday ordered a lower federal court to reexamine California restrictions on indoor religious services in areas hard-hit by the coronavirus in light of the justices' recent ruling in favor of churches and synagogues in New York.
The court's unsigned order, with no noted dissent, leaves the California restrictions in place for now. But it throws out a federal district court ruling that rejected a challenge to the limits from Pasadena-based Harvest Rock Church and Harvest International Ministry, which has more than 160 churches across the state.
Last week, the Supreme Court split 5-4 in holding that New York could not enforce certain limits on attendance at churches and synagogues.
The governor's heightened restrictions include a ban on indoor singing and chanting.
EX-PRESIDENTS STEP UP
Three former presidents say they are willing to take a vaccine publicly once one becomes available, to encourage all Americans to get inoculated.
Former President Barack Obama said on SiriusXM radio Thursday: "I promise you that when it's been made for people who are less at risk, I will be taking it."
"I may end up taking it on TV or having it filmed," Obama added, "just so that people know that I trust this science."
That may not be possible for a while. The Food and Drug Administration will consider authorizing emergency use of two vaccines made by Pfizer and Moderna this month, but current estimates project that no more than 20 million doses of each will be available by the end of this year. Each product also requires two doses, meaning shots will be rationed in the early stages.
Former President Bill Clinton is "definitely" willing to get a vaccine, as soon as one is "available to him, spokesman Angel Urena said in a statement Thursday.
"And he will do it in a public setting if it will help urge all Americans to do the same," Urena said.
Former President George W. Bush's chief of staff, Freddy Ford, told CNN that Bush recently asked him to meet with Dr. Anthony Fauci, the nation's top infectious disease expert, and Dr. Deborah Birx, the White House coronavirus response coordinator, to let them "know that, when the time is right, he wants to do what he can to help encourage his fellow citizens to get vaccinated."
"First, the vaccines need to be deemed safe and administered to the priority populations," Ford told the network. "Then, President Bush will get in line for his, and will gladly do so on camera."
The only other living former president, Jimmy Carter, who at 96 is the oldest ex-president in U.S. history, also encouraged people to get vaccinated, but stopped short of pledging to do so himself.
"Jimmy Carter and his wife, Rosalynn, said today that they are in full support of COVID-19 vaccine efforts and encourage everyone who is eligible to get immunized as soon as it becomes available in their communities," the Carter Center said.
President Donald Trump was asked this summer if he would consider being the first to take the vaccine to send a message that it was safe. He said going first could lead to accusations that he was being selfish, but that he would take it if it was recommended.
"I would absolutely, if they wanted me to, if they thought it was right. I would take it first or I would take it last," Trump said in a July interview with Fox News.
Biden told CNN in an interview Thursday that he too would be happy to get his vaccine publicly to encourage people to follow suit.
Information for this article was contributed by Sam Metz, Ryan J. Foley, Adam Beam, Kathleen Ronayne, Will Weissert, Andrew DeMillo, Geoff Mulvihill, Jim Anderson, Bob Christie, Steve Karnowski, Sophia Eppolito, Tammy Webber, Kevin Freking, Darlene Superville, Adrian Sainz and staff members of The Associated Press.
